CELTICS GREEN BLOG by and for boston celtics fans: A Most Common Affliction

by FLCeltsFan 10:22 PM

A few years ago, not many people had heard of plantar fasciitis but in recent years, it seems that every year several players come down with it. The earliest reference I could find was in 2001 when Shaq was diagnosed with plantar fasciitis. In 2004, Rashard Lewis missed time because of it. In 2005, there were Pau Gasol, Ira Newble, and Tim Duncan who were sidelined with plantar fasciitis. In 2006, Sam Cassell, PJ Brown, Marcus Camby, Bobby Simmons, and Mo Williams were diagnosed with this injury. And in 2007, Andres Nocioni, Shawn Marion, Brad Miller, Larry Hughes, Chris Bosh, and the Celtics own Kendrick Perkins suffered from the injury.
I am sure there were even more but I found all these with just a quick search. It certainly seems as though it is an injury that is becoming more prevalent or maybe they are just getting better at diagnosing it. Every time we turn around it seems another player is sitting out due to this injury. Since many people may not be aware of what plantar fasciitis is, I thought I would discuss it here.

The plantar fascia is the flat band of tissue (ligament) that connects your heel bone to your toes. It supports the arch of your foot. If you strain your plantar fascia, it gets weak, swollen, and irritated and inflamed. Plantar fasciitis refers to the inflammation of the plantar fascia. The inflammation in the tissue is the result of some type of injury to the plantar fascia, typically from repeated trauma such as running or walking on hard surfaces.

Plantar fasciitis typically starts as a dull, intermittent pain in the heel and may progress to sharp, constant pain. It is usually worse in the morning or after sitting, and then decreases as the person begins to walk around. In addition, the pain usually increases after standing or walking for long periods of time, and at the beginning of a sporting activity, such as playing basketball. Repeated straining of the plantar facia can cause tiny tears in the ligament. There are several factors that can lead to plantar fasciitis including if your feet roll inward too much when you walk; if you have high arches or flat feet; if you walk, stand, or run for long periods of time, especially on hard surfaces (this would be the factor that would most likely fit the NBA players who suffer this injury); if you are overweight; if you wear shoes that don't fit well or are worn out; and if you have tight Achilles tendons or calf muscles.

Treatments for PF are varied but all are intended to reduce the amount of inflammation within the plantar fascia either directly or indirectly. Direct treatment can be oral and/or injected medicines or topical medications under ultrasound. Oral medications such as Motrin, Ibuprofen, Naprosyn and Celebrex are usually the first line of direct treatment. These medications are used to reduce the inflamation. Oral steroids can be used to directly affect the inflammation as well.

A second type of direct treatment includes injections into the bottom of the foot, which concentrate the anti-inflammatory medications directly at the affected site. These medicines are most commonly short and long acting steroids.

The most important treatment for plantar fasciitis is rest. Since activity most often causes it, you have to stop the activity to allow it to heal. Also, applying ice to the area and stretching the Achilles tendon before standing will help relieve pain. Night splints can be worn to keep the heel stretched out when you sleep. By doing so, the arch of the foot does not become contracted at night, and is hopefully not as painful in the morning.

Most cases of plantar fasciitis will heal with rest and treatment as described above, but more severe cases that don't react to treatment may require surgery. For the most part, players will heal with rest and treatment, and not experience any recurrences but some players, such as Tommy Heinsohn are plagued with pain that causes them to retire because of it. When players are diagnosed with plantar fasciitis, the recovery time can be anywhere from 6 months to several years.

Hopefully the Celtics will be spared from having to deal with this injury this year since we had more than our share of injuries including plantar fasciitis last season. But, it seems a sure thing that at least a few players will be diagnosed with plantar fasciitis this season and hopefully you will now be able to better understand it.

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